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SUMMARY
Breast milk is the optimal form of nutrition for babies and breastfeeding
offers a range of health benefits for both mother and child.
For the
child, breastfeeding reduces the risk of
- Diarrhoea
- Hospital admission
for lower respiratory tract disease
- Acute otitis media
- Diabetes
(types 1 and 2)
- Obesity (in adolescence and adulthood)
- Atopic
dermatitis
- Childhood asthma
- Inflammatory bowel disease
- Sudden
infant death
syndrome
- Urinary tract infections
- Acute lymphocytic
leukaemia
- Necrotising enterocolitis (a common gastrointestinal
emergency
in
premature babies)
Breastfeeding appears to increase intelligence quotient
and decrease the incidence of dental malocclusion. It also lowers blood
pressure
(1.21mmHg systolic and 0.49mmHg diastolic) and total and low density
lipoprotein cholesterol (0.18mmol/L and 0.2mmol/L, respectively)
in adulthood.
For the mother, breastfeeding reduces the risks of breast and ovarian
cancer, type 2
diabetes, rheumatoid arthritis and osteoporosis. Mothers who breastfeed
are also less likely to suffer from postnatal depression.
Women most likely to breastfeed are:
• First time mothers
• Those who successfully breastfed a previous baby
• Those who left further education after the age of 18 years
• Those in managerial or professional occupations
• Older mothers (eg, 84 per cent of mothers aged 34 years or over compared
with 51 per cent of mothers aged 20 years or under)
• Those from minority ethnic groups
In 2005 the initial breastfeeding rate (ie, just after delivery) in
England was 78 per cent. It was 70 per cent in Scotland, 67 per cent
in Wales and 63 per cent in Northern Ireland.
Nevertheless, according
to a survey in the same year, 40 per cent of mothers stopped breastfeeding
two weeks after delivery because they perceived that the baby would
not suck, 21 per cent stopped because of painful breasts or nipples,
while
29 per cent said they had insufficient milk.
Other reasons given included:
breastfeeding took too long or was tiring;
illness (mother or child); a dislike of breastfeeding; and the fact
that the baby could not be fed by others.
It is important to note, however,
that most mothers said they would have liked to have breastfed for
longer. Full article PDF 90K
Expressing and storing
milk
Many women now express their milk so their babies
can continue to receive breastmilk in their absence (eg, while
they are at work).
Pharmacists can advise mothers that expressed milk can be stored
for: • Up to five days in the main part of a refrigerator at 4C or
lower
• Up to two weeks in the freezer compartment of a refrigerator
• Up to six months in a domestic freezer at –18C or lower
Mothers who wish to store breast milk for less than
five days can be advised that refrigeration preserves its properties
more
effectively than freezing. Frozen breast milk should be defrosted
in a fridge and should not be refrozen once thawed.
Microwave ovens
should never be used to warm or defrost breast milk because they
can cause uneven heating and result in scalding hot liquid. Microwaving
also denatures the proteins in breast milk. |
Indicators
of good positioning and attachment *
• The baby’s mouth is wide open
• Less areola is visible underneath the baby’s chin than above
the nipple
• Chin touching the breast, lower lip rolled down and nose free
• The mother experiences no pain on latch or during the feed
• Audible and visible swallowing of milk
• Sustained rhythmic suck
• The baby’s arms and hands are relaxed
• The baby’s mouth is moist, indicating it is well hydrated
• Regular soaked or heavy nappies
• The mother’s breast softens after feeds
• No change in shape of the nipple after feeds (indicating lack of
compression)
• The mother feels relaxed and sleepy during and after feeds (an
effect of prolactin)
*Adapted from the NICE clinical guidelines on postnatal
care |
Signposting
The National Breastfeeding Helpline 0844 2090920
Baby Café is a charitable trust that provides
drop-in centres to support breastfeeding mothers
Search for
local centres
Volunteers registered with the Breastfeeding
Network may also run breastfeeding
centres and breastfeeding
groups are organised by the Association of Breastfeeding
Mothers
The Breastfeeding Network offers
independent support and information for breastfeeding women
NHS information on breastfeeding
Sure Start is
a Government programme bringing together early education, childcare,
health and family support Resources
The Breastfeeding Network drugline (tel 0844 412
4665) provides advice and information on the safety of drugs in
breastmilk
The NICE review of maternal
and child nutrition and guidance
on improving the nutrition of pregnant or breastfeeding mothers
and children in low-income households
The Drugs
and Lactation Database (LactMed)
UNICEF’s Baby
Friendly Initiative works with the healthcare
system to ensure a high standard of care for pregnant women and
breastfeeding mothers and babies
An e-learning programme (Medicines & mothers — challenges
in breastfeeding) from NHS Education for Scotland |
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The
Pharmaceutical Journal